New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter III - Policy and Certificate Provisions
Subchapter A - Life, Accident and Health Insurance
Part 52 - Minimum Standards For Form, Content And Sale Of Health Insurance, Including Standards Of Full And Fair Disclosure
Section 52.47 - Monitoring of experience data submitted under section 52.44(a) of this part

The superintendent shall monitor the experience data submitted in accordance with section 52.44(a) of this Part, for the purpose of assuring compliance with the minimum loss ratio standards of this Part. If, after considering the data submitted by an insurer in accordance with section 52.44(a), and such other data as may have been furnished, the superintendent finds the applicable loss ratio standard will not be met over the past and future lifetime of the policy form, the superintendent will notify the insurer that a plan for assuring compliance with such applicable minimum loss ratio standard must be submitted within 90 days to the superintendent. The insurer's plan may utilize premium reductions, dividends, benefit increases, premium refunds or credits, or any combination of these or other methods such that the loss ratio standard described can reasonably be expected to be achieved; however, such plan is subject to approval by the superintendent. In most instances, benefit increases may not be included as part of the insurer's plan without offering the alternative option of appropriate premium reduction. Failure to submit such a plan within the required time period will be a violation of this regulation and will subject the insurer to the penalties of section 109 of the Insurance Law.